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Monthly State Update:
MAJOR DEVELOPMENTS IN 2012

(as of 09/01/2012)

This
update provides information on legislation, as well as relevant
executive branch actions and judicial decisions in states across
the country. For each of the topics listed below, the number of
states in which legislation has been introduced is given, as are
the names of the states in which subsequent action has been taken.
Detailed summaries are provided for legislation that has been passed
by at least one house of a legislature and for major court decisions;
actions for the current month are in bold. For an archive of previous
monthly updates, click here.

ABORTION

Abortion Bans to Replace Roe

MISSISSIPPI: In April, the House passed a measure that would prohibit abortion if the fetal heartbeat can be detected, except in cases of life endangerment, rape or incest. The bill died in the Senate.

MISSISSIPPI: In March, the House passed a measure that would ban abortion after a fetal heartbeat is detected. The bill would require women seeking an abortion to undergo an examination to determine if the fetal heartbeat is present. If a heartbeat is detected, the woman would be required to undergo counseling on “the statistical probability of bringing the unborn human individual to term.” The bill contains an exception for cases of life endangerment or risk of “substantial and irreversible impairment” to physical health. The bill missed a procedural deadline in the Senate and can no longer be considered.

OKLAHOMA: In April, the House defeated a measure that could have potentially restricted women’s access to birth control and abortion services by changing the definition of “person” in the Oklahoma public health code to apply to “all unborn children or the offspring of human beings from the moment of conception until birth.” The bill had passed the Senate in February.

OKLAHOMA: In April, the Oklahoma Supreme Court blocked a ballot initiative to amend the constitutional definition of “person” to include “every human being…from the beginning of biological development to natural death.” The court held that the initiative was designed to ban abortion, which would be unconstitutional under rulings of the U.S. Supreme Court.

VIRGINIA: In February, a Senate committee defeated a bill that could have potentially restricted women’s access to birth control and abortion services by redefining the word “person” throughout Virginia law to include “any unborn child or children or the offspring of human beings from the moment of conception until birth.”

(ENACTED) ARIZONA: In April, Gov. Jan Brewer (R) signed an omnibus abortion measure, which includes a provision that requires a provider who performs a surgical abortion to have admitting privileges at a hospital within 30 miles of the abortion facility. Current law requires an abortion provider to have admitting privileges at a hospital in the state. The bill, which also includes provisions on clinic regulations, limits on abortion at a specific gestational age, ultrasound, medication abortion and abortion counseling, goes into effect later this year.

INDIANA: In February, the Senate passed a measure that would require all medication abortion providers to have hospital privileges at a hospital that is in the same county as the abortion clinic or in an adjacent county to handle complications from an abortion. The bill also contains provisions on abortion counseling and medication abortion. No further action is expected since the legislature has adjourned its regular session.

MISSISSIPPI: In July, a U.S. district court judge allowed enforcement of a law that requires any abortion provider associated with an abortion facility to have admitting privileges at a local hospital. The law also requires abortion providers to be certified in obstetrics and gynecology or eligible for such certification. However, the judge ruled that Jackson Women’s Health Organization, the only abortion clinic in the state, may not yet be penalized for “operating without the relevant privileges during the administrative process.”

(ENACTED) TENNESSEE: In May, Gov. Bill Haslam (R) signed a measure that requires an abortion provider to have admitting privileges at a hospital located in the same county as the abortion facility or in an adjacent county. The new law goes into effect in July.

ALABAMA: In May, the House adopted an omnibus abortion measure that would amend the state’s laws on abortion clinics by requiring that all abortion facilities meet certain physical plant requirements as determined by state regulations. Facilities would have two years to comply with the requirements. The bill would also limit provision of medication abortion, permit only physicians to provide abortions and require reporting of statutory rape. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) ARIZONA: In April, Gov. Jan Brewer (R) signed an omnibus abortion measure, which includes a provision that requires the state to revise abortion clinic regulations. The revisions include rules on follow-up procedures after a medication abortion, reporting of serious injuries and new penalties for noncompliance. The bill, which also includes provisions on hospital admitting privileges for abortion providers, limits on abortion at a specific gestational age, ultrasound, medication abortion and abortion counseling, goes into effect later this year.

FLORIDA: In March, the House adopted an omnibus abortion bill that would require the owner of an abortion clinic to be a physician who has received abortion training. The provision would have applied only to abortion facilities licensed after July 1, 2012. The bill, which would have also amended Florida law regarding limits on abortion at a specific gestational age, “partial-birth” abortion, postviability abortion, abortion counseling, waiting periods and abortion reporting, died at the end of the regular session.

MICHIGAN: In June, the House passed an omnibus abortion measure that would revise the state’s abortion clinic licensing law. The bill would require any abortion provider who performs or administers at least five abortions per month to meet the licensing requirements for ambulatory surgical centers. Currently, providers must meet the ambulatory surgical center requirements if at least half of their patients obtain abortions. The bill, which also addresses physician liability, abortion counseling and medication abortion, is awaiting action by the Senate.

MINNESOTA: In April, Gov. Mark Dayton (D) vetoed a measure that would have regulated facilities that provide at least 10 abortions per month, but not other similar outpatient health care facilities. The bill passed the House and Senate in April.

Crisis Pregnancy Centers

''Choose Life' License Plates

Click here for current status of state policy on 'Choose Life' License Plate laws

Introduced in 7 states

Bill Status:

Enacted in AK

(ENACTED) ALASKA: In March, Gov. Sean Parnell (R) signed into law a measure that authorizes the production of “Choose Life” license plates. Funds raised by the sale of these plates shall be distributed by the legislature to programs that support adoption. The law is in effect.

MISSOURI: In May, the House passed a measure that would prohibit the state from enforcing any regulation that “prohibits, restricts, limits, controls, directs, interferes with, or otherwise adversely affects” crisis pregnancy centers from incorporating religion into their practices. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) SOUTH DAKOTA: In March, Gov. Dennis Daugaard (R) signed into a law a measure that would amend state abortion counseling requirements enacted in 2011 that never went into effect because of a court order. The new law would require that abortion counseling include information on any research showing that some women (based on their “physical, psychological, demographic or situational” characteristics) may be at higher risk of negative mental health outcomes associated with an abortion; the 2011 provision required information on a much broader range of potential negative outcomes. Another provision of the 2011 law required a woman seeking an abortion to visit a crisis pregnancy center approved by the state; the new law requires centers to have a licensed medical or mental health professional on staff. The measure goes into effect in July.

(ENACTED) ALASKA: In May, Gov. Sean Parnell (R) signed a measure that allocates $200,000 for the creation of a crisis pregnancy center. The measure is in effect.

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed into law a measure that allocates more than $300,000 to fund alternatives-to-abortion services. The bill also funds family planning services, reenacts a priority-based system for distributing family planning funds and limits state employee participation in abortion. The new law is in effect.

(ENACTED) MICHIGAN: In June, Gov. Rick Snyder (R) signed into law a measure that allocates $2 million for alternatives to abortion and services for pregnant women. The current program offers a range of services to a woman during her pregnancy and for one year following birth. The new law, which also contains a restriction on family planning funds and funding levels for family planning, is in effect.

(ENACTED) MINNESOTA: In April, Gov. Mark Dayton (D) signed a measure that amends the requirements for organizations seeking funding for alternatives to abortion programs. The bill expands eligibility for alternatives to abortion grants to organizations that have had operational programs since 2011 instead of 2005. The measure is currently in effect.

(ENACTED) MISSOURI: In June, Gov. Jay Nixon (D) approved an appropriations bill that allocates more than $1.6 million for alternatives-to-abortion services for pregnant women. The new law goes into effect in August.

MISSOURI: In April, the House passed a measure that would require state entities that receive monies from certain federal grants to evaluate whether any of the funds can be diverted to alternatives-to-abortion programs. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) PENNSYLVANIA: In June, Gov. Tom Corbett (R) signed into law the state’s budget that allocates more than $6 million to provide alternatives to abortion and services for pregnant women. The new law, which also allocates funding for family planning, is in effect.

Insurance Coverage of Abortion

Introduced in 14 states (These bills may overlap with bills in Private Insurance Coverage.)

Bill Status:

Passed at least one chamber in MO

Enacted in AL, SC, SD and WI

(ENACTED) ALABAMA: In May, Gov. Robert Bentley (R) signed into law a measure that bans abortion coverage in the health exchanges that will be established under the federal health care reform law except in cases of life endangerment, rape, incest or ectopic pregnancy. The bill goes into effect in August.

MISSOURI: In May, the House passed a measure that would ensure the rights of individuals to refuse health coverage for abortion without incurring penalties. The measure would also allow insurance purchasers, such as employers, and insurance providers to opt out of providing coverage for abortion care. The bill would also authorize the state Attorney General to protect these rights with regard to the federal health care law. The bill, which passed the Senate in March, is awaiting action by Gov. Jay Nixon (D).

(ENACTED) SOUTH CAROLINA: In June, Gov. Nikki Haley (R) signed into law a measure that bans abortion coverage in the health insurance exchange that will be established under the federal health care reform law except in cases of life endangerment, rape or incest. The new law is in effect.

(ENACTED) SOUTH DAKOTA: In March, Gov. Dennis Daugaard (R) signed into law a measure that bans abortion coverage in the health insurance exchange that will be established under the federal health care reform law except in cases of life endangerment or possible risk of “substantial and irreversible impairment of a major bodily function.” The bill, which passed the legislature in February, goes into effect in July.

(ENACTED) WISCONSIN: In April, Gov. Scott Walker (R) signed a measure that bans abortion coverage in the health exchanges that will be established under the federal health care reform law except in cases of life endangerment, rape, incest or possible “grave, long-lasting physical health damage.” The law is in effect.

GEORGIA: In March, the Senate passed a measure that would prohibit the state employees’ health plan from covering abortion except in cases of life endangerment or risk of “substantial or irreversible physical impairment of a major bodily function.” No further action is expected since the legislature has adjourned its regular session.

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that includes a provision that would prohibit individuals from claiming a tax credit for the amount spent to purchase a rider for insurance coverage of abortion. The bill would also amend the state laws on postviability abortion, abortion at 20 weeks postfertilization, abortion counseling, provider liability, abortion training programs, abortion based on gender, tax credits for organizations that provide abortions, and sex education. No further action is expected since the legislature has adjourned its regular session.

MISSOURI: In July, Gov. Jay Nixon (D) vetoed a measure that would have allowed individuals to refuse health coverage for abortion without incurring penalties. The measure would have also allowed insurance purchasers, such as employers, and insurance providers to opt out of providing coverage for abortion care. In addition, the bill would have authorized the state Attorney General to protect these rights with regard to the federal health care law. The measure was approved by the legislature in May.

OKLAHOMA: In May, a conference committee removed language from a bill that would have allowed an enrollee in a health plan to opt out of abortion or contraceptive coverage if the objection is based on religious beliefs.

SOUTH CAROLINA: In June, the legislature passed a measure that would continue a long-standing provision that prohibits the state employees’ health plan from covering abortion except when necessary to save the woman’s life or in cases of rape or incest. In a new twist, the measure would permit taxpayer dollars to be used to pay only for abortions in cases of life endangerment: the cost of abortions in cases of rape or incest would be covered by employees’ premiums. The bill, which also allocates funding for family planning services, is awaiting action by Gov. Nikki Haley (R).

(ENACTED) ALASKA: In May, Gov. Sean Parnell (R) signed a budget bill that would limit Medicaid funding for abortion to cases of rape, incest or life endangerment. Currently, the state is under a court order to fund all medically necessary abortions, which supersedes the provision in the budget.

(ENACTED) MARYLAND: In April, Gov. Martin O’Malley (D) approved an appropriations bill that would reenact current restrictions limiting public funding of abortion to cases of incest, rape, life or health endangerment and fetal impairment. The bill will go into effect in July.

VIRGINIA: In February, a Senate committee defeated a measure that would have limited coverage of abortion under Medicaid to cases of life endangerment, rape or incest. Currently, Medicaid covers abortion in those circumstances and in cases of fetal impairment.

WASHINGTON: In February, the House approved a measure that would require health plans that cover maternity care to also cover abortion care unless the purchaser of the health plan opts out of the coverage. The measure is currently awaiting action in the Senate.

Later Term Abortion

FLORIDA: In March, the House adopted an omnibus abortion bill that would amend the definition of “partial-birth” abortion to match the federal law. The bill, which would have also amended Florida law regarding clinic regulations, limits on abortion at a specific gestational age, postviability abortion, abortion counseling, waiting periods and abortion reporting, died at the end of the regular session.

(ENACTED) NEW HAMPSHIRE: In June, the legislature overrode Gov. John Lynch’s (D) veto of a measure that prohibits “partial-birth” abortion except when a woman’s life is endangered or when her physical health is in severe jeopardy. The bill requires an abortion provider and another physician who is unaffiliated with the provider to certify that the use of “partial-birth” abortion is necessary to save the woman’s life or protect her physical health. The measure’s definition of “partial-birth” abortion mirrors the federal definition as upheld by the U.S. Supreme Court. The law goes into effect in January 2013.

FLORIDA: In March, the House adopted an omnibus abortion bill that would ban abortion after viability except when a woman’s life is endangered or when there is a serious risk of “substantial and irreversible” impairment to her physical health. A second physician would be required to certify the need for the abortion and the procedure would have had to have been conducted in a hospital. The bill, which would have also amended Florida law regarding clinic regulations, limits on abortion at a specific gestational age, “partial-birth” abortion, abortion counseling, waiting periods and abortion reporting, died at the end of the regular session.

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that includes a provision that would further restrict abortions after viability by narrowing the health exception to allow an abortion only when the woman’s physical health is endangered. The bill would also amend the state laws on abortion coverage, abortion at 20 weeks postfertilization, abortion counseling, provider liability, abortion training programs, abortion based on gender, tax credits for abortion-providing organizations, and sex education. No further action is expected since the legislature has adjourned its regular session.

ARIZONA: In August, the U.S. Court of Appeals for the Ninth Circuit blocked enforcement of a new law that would ban abortion at 18 weeks postfertilization (or 20 weeks after the woman’s last menstrual period) except when the procedure is necessary to protect the woman’s life or prevent “substantial and irreversible impairment” to her health. The law will remain unenforced until resolution of the court case.

FLORIDA: In March, the House adopted an omnibus abortion bill that would ban abortion after 24 weeks of pregnancy or when a physician determines the fetus to be viable. An abortion would be permitted when a woman’s life is endangered or when there is a serious risk of “substantial and irreversible” impairment to her physical health. A second physician would be required to certify the need for the abortion and the procedure would have had to have been conducted in a hospital. The bill, which would have also amended Florida law regarding clinic regulations, “partial-birth” abortion, postviability abortion, abortion counseling, waiting periods and abortion reporting, died at the end of the regular session.

(ENACTED) GEORGIA: In May, Gov. Nathan Deal (R) signed a measure that bans abortion at 20 weeks postfertilization based on an assumption that a fetus can feel pain at that point of development. The bill permits abortions at or beyond 20 weeks postfertilization to protect the woman’s life, avert “substantial and irreversible” damage to her physical health or terminate a pregnancy that has been diagnosed as “medically futile” due to fetal anomaly. The bill, which also contains provisions on abortion reporting requirements, goes into effect in 2013.

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that includes a provision that would further restrict abortions after 20 weeks postfertilization by narrowing the health exception to allow an abortion only when the woman’s physical health is endangered. The bill would also amend the state laws on abortion coverage, postviability abortion, abortion counseling, provider liability, abortion training programs, abortion based on gender, tax credits for abortion providing organizations, and sex education. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) LOUSIANA: In June, Gov. Bobby Jindal (R) signed into law a measure that bans abortion at 20 weeks after fertilization based on an assumption that a fetus can feel pain at that point of development. The law permits abortions after that point to protect the woman’s life, avert “substantial and irreversible” damage to her physical health or terminate a pregnancy deemed “medically futile” due to fetal anomaly. The new law goes into effect in August.

NEW HAMPSHIRE: In April, the Senate directed the state to study the issues surrounding a potential ban on abortion at 20 weeks postfertilization (or 22 weeks after the woman’s last menstrual period) in an amendment to a House bill that would ban abortion at 20 weeks postfertilization.

(ENACTED) ARIZONA: In April, Gov. Jan Brewer (R) signed an omnibus abortion measure, which includes a provision that requires the state to develop counseling materials that include information on coerced abortion and the “possible detrimental psychological effects of abortion.” The bill requires a woman seeking an abortion because of fetal impairment to receive counseling on individuals living with those conditions and the availability of perinatal hospice care if the impairment will be fatal. The bill, which also includes provisions on hospital admitting privileges for abortion providers, clinic regulations, limits on abortion at a specific gestational age, ultrasound and medication abortion, goes into effect later this year.

INDIANA: In February, the Senate passed a measure that would require the state to develop written materials for abortion counseling that include information about fetal development, abortion-related risks, pregnancy-related risks, organizations that can provide assistance and child support. The bill also contains provisions on medication abortion and hospital privileges for providers. No further action is expected since the legislature has adjourned its regular session.

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that would amend the state’s counseling requirements. The bill would require that counseling include information on fetal pain and statements that having an abortion increases a woman’s risk of breast cancer and “premature birth in future pregnancies.” The measure also prescribes text for written counseling materials that includes information about fetal development and alternatives to abortion. The bill would also amend the state laws on abortion coverage, postviability abortion, abortion at 20 weeks’ gestation, provider liability, abortion training programs, abortion based on gender, tax credits for abortion-providing organizations, and sex education. No further action is expected since the legislature has adjourned its regular session.

(ENACTED)LOUISIANA: In June, Gov. Bobby Jindal (R) signed into law a measure that requires a provider to make the fetal heartbeat audible to the woman at least 24 hours before an abortion. The woman could opt not to listen to the heartbeat. The new law goes into effect in August.

MICHIGAN: In June, the House passed an omnibus abortion measure that would require, as part of abortion counseling, that a provider determine whether a woman is being coerced into the abortion. The measure would also require abortion counseling materials to include information on coerced abortion and organizations that support victims of domestic violence. The bill, which also addresses physician liability, medication abortion and clinic regulations, is awaiting action in the Senate.

(ENACTED)OKLAHOMA: In April, Gov. Mary Fallin (R) signed a measure that would require abortion providers to attempt to hear the fetal heartbeat if a woman is seeking an abortion at least eight weeks postfertilization (or six weeks after her last menstrual period). The provision contains an exception for medical emergencies. The bill will go into effect in November.

SOUTH DAKOTA: In July, the U.S. Court of Appeals for the Eighth Circuit allowed enforcement of a 2005 law that requires abortion counseling to include information that abortion is linked to suicide and suicidal thoughts. The court ruled that this requirement does not constitute “compelled speech” and the information is “truthful” and “nonmisleading.”

SOUTH DAKOTA: In June, a U.S. District Court judge allowed portions of a contested 2011 law amending the state’s abortion counseling requirements to go into effect. Physicians will now have to conduct preabortion counseling and screen patients for evidence of coercion. During counseling, physicians are now required to assess patients for “risk factors associated with adverse psychological outcomes following an abortion,” and describe these outcomes to the woman. Other provisions of the law, including the 72-hour waiting period and the requirement that a woman seeking an abortion must visit a crisis pregnancy center before obtaining an abortion, remain blocked from enforcement.

(ENACTED) SOUTH DAKOTA: In March, Gov. Dennis Daugaard (R) signed into a law a measure that would amend state abortion counseling requirements enacted in 2011 that never went into effect because of a court order. The new law would require that abortion counseling include information on any research showing that some women (based on their “physical, psychological, demographic or situational” characteristics) may be at higher risk of negative mental health outcomes associated with an abortion; the 2011 provision required information on a much broader range of potential negative outcomes. Another provision of the 2011 law required a woman seeking an abortion to visit a crisis pregnancy center approved by the state; the new law requires centers to have a licensed medical or mental health professional on staff. The measure goes into effect in July.

TEXAS: In February, a US District Court judge allowed the state's law requiring an ultrasound before an abortion to go into effect. A woman who lives within 100 miles of the abortion facility must obtain the ultrasound at least 24 hours before the abortion, thus requiring her to make two trips to the facility. The provider must give her a detailed verbal description of the image unless she was raped, has a court order waiving parental consent or is ending the pregnancy because of a fetal abnormality.The provider will also offer her the option of viewing the image and listening to the fetal heartbeat.

(ENACTED) WISCONSIN: In April, Gov. Scott Walker (R) signed a measure amending abortion counseling provisions to require that a provider determine whether a woman is being coerced into the abortion. The measure also requires abortion counseling materials to include information on organizations that support victims of domestic violence. The bill, which also prohibits the use of telemedicine to administer medication for abortion and limits provision of medication abortion to physicians, went into effect in April.

FLORIDA: In March, the House adopted an omnibus abortion bill that would require a woman seeking an abortion to receive counseling in person at least 24 hours prior to the procedure, thus requiring her to make two trips to the clinic. The measure also would have expanded the state’s counseling requirements so that any woman seeking an abortion after 19 weeks of pregnancy would receive information on the fetus’s purported ability to feel pain. The bill, which would have also amended Florida law regarding clinic regulations, limits on abortion at a specific gestational age, “partial-birth” abortion, postviability abortion and abortion reporting, died at the end of the regular session.

KENTUCKY: In February, the Senate approved a measure that would require informed consent counseling to be conducted in person, necessitating two trips to the clinic for women seeking abortion care. No further action is expected since the legislature has adjourned its regular session.

NEW HAMPSHIRE: In May, the House approved a bill that would require that a woman seeking an abortion receive counseling in person at least 24 hours prior to the procedure, thus requiring her to make two trips to the clinic. The counseling must include information on the specific abortion procedure to be performed, any risks associated with that procedure and any health risks associated with continuation of the pregnancy. The provider must inform the woman that she has the right to withdraw consent at any time. The woman must also be given information on abortion alternatives. No further action is expected since the Senate refused to take up the measure.

NEW HAMPSHIRE: In April, the Senate defeated a bill that would have required that a woman seeking an abortion receive counseling in person at least 24 hours prior to the procedure, thus requiring her to make two trips to the clinic. The counseling would have included information on the specific abortion procedure to be performed, any risks associated with that procedure and any health risks associated with continuation of the pregnancy. The measure would have required that the woman also be given information on abortion alternatives. The bill passed the House in March.

(ENACTED) UTAH: In March, Gov. Gary Herbert (R) approved a measure that requires a woman seeking an abortion to receive informed consent counseling at least 72 hours before obtaining an abortion. Under current law, the waiting period is 24 hours. Women at risk of serious infection may obtain abortion care before the 72-hour waiting period has elapsed. Women may receive informed consent counseling at any location in the state, not just at the clinic. The law goes into effect in May.

(ENACTED) VIRGINIA: In March, Gov. Bob McDonnell (R) signed into law a measure that requires a woman who lives within 100 miles of the abortion facility to obtain an ultrasound at least 24 hours before the abortion, thus requiring her to make two trips to the facility. A woman who lives more than 100 miles away from an abortion provider must obtain an ultrasound at least two hours before the abortion. The bill contains an exception for victims of rape or incest that has been reported to the appropriate authorities. The law, which passed the legislature in February, goes into effect in July.

Medication
Abortion

ALABAMA: In May, the House adopted an omnibus abortion measure that would require a physician to examine a patient in person before prescribing medication for abortion, effectively banning telemedicine. The bill also includes provisions on clinic regulation, would permit only physicians to provide abortions and require reporting of statutory rape. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) ARIZONA: In April, Gov. Jan Brewer (R) signed an omnibus abortion measure, which includes a provision that requires providers to use the FDA protocol when providing medication abortion; this provision blocks use of newer regimens that are as safe and effective but have fewer side effects and a lower cost. The bill, which also includes provisions on hospital admitting privileges for abortion providers, clinic regulations, limits on abortion at a specific gestational age, ultrasound and abortion counseling, goes into effect later this year.

INDIANA: In February, the Senate passed a measure that would require a physician to examine a patient in person before prescribing medication for abortion, effectively banning telemedicine. The bill also contains provisions on abortion counseling and hospital privileges for providers. No further action is expected since the legislature has adjourned its regular session.

MICHIGAN: In June, the House passed an omnibus abortion measure that would require a physician to examine a patient in person before prescribing medication for abortion, effectively banning telemedicine. The bill also includes a provision that requires providers to use the FDA protocol when providing medication abortion; this provision blocks use of newer regimens that are as safe and effective but have fewer side effects and a lower cost. The measure, which also addresses physician liability, abortion counseling and clinic regulations, is awaiting action in the Senate.

MINNESOTA: In April, Gov. Mark Dayton (D) vetoed a measure that would have prohibited physicians from prescribing medication for abortion remotely through telemedicine. The measure passed the House and Senate in April.

MISSISSIPPI: In March, the House passed a measure that would prohibit physicians from prescribing medication for abortion remotely through telemedicine. The bill would also revise the state’s abortion reporting requirements.The bill missed a procedural deadline in the Senate and is no longer under consideration.

MISSOURI: In April, the Senate passed a measure that would prohibit prescribing medication for abortion remotely through telemedicine. The measure also contains a provision that would permit medication abortion only in abortion facilities and hospitals. The bill also includes provisions on physician liability and physician-only requirements. No further action is expected since the legislature has adjourned its regular session.

OKLAHOMA: In May, a state district court struck down a law that required providers to use the FDA protocol when providing medication abortion; this provision blocks use of newer regimens that are as safe and effective but have fewer side effects and a lower cost. The court ruled that the law was “completely at odds with the standard that governs the practice of medicine” and, as such, its only purpose was to discourage abortions. The case is expected to be appealed to the Oklahoma Supreme Court.

(ENACTED) OKLAHOMA: In May, Gov. Mary Fallin (R) approved a measure that prohibits a physician from prescribing medication for abortion remotely through telemedicine. The measure goes into effect in November.

OKLAHOMA: In April, the House passed a measure that would exclude any medication to be used for the purpose of inducing an abortion from the expansion of prior authorization for drugs under Medicaid. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) TENNESSEE: In April, Gov. Bill Haslam (R) signed a measure that changes the effective date of a previously enacted ban on the provision of medication abortion via telemedicine from January 1, 2013 to July 1, 2012.

(ENACTED) WISCONSIN: In April, Gov. Scott Walker (R) signed a measure that prohibits the use of telemedicine to administer medication for abortion and limits provision of medication abortion to physicians. The bill, which also amends the state’s abortion counseling law, went into effect in April.

Parental Involvement in Minor's Abortions

MICHIGAN: In March, the Senate passed a measure that would require a judge to consider specific criteria to determine if the minor is mature and informed before waiving the state’s parental consent requirement. The measure would also limit a minor’s ability to appeal an unfavorable decision. The bill is currently awaiting action in the House.

(ENACTED) NEW HAMPSHIRE: In May, Gov. John Lynch (D) signed a measure that would revise the state’s judicial bypass proceedings related to a minor’s abortion to give the court two business days (rather than 48 hours) to rule on a judicial bypass request. The new law is in effect.

Physicians

Physician Liability

Introduced in 9 states

Bill Status:

Passed at least one chamber in KS and MO

Enacted in AZ, MI and OK

(ENACTED) ARIZONA: In April, Gov. Jan Brewer (R) signed a measure that would allow a medical professional to withhold information from a woman about her pregnancy that may have resulted in her obtaining an abortion. The bill will go into effect later this year.

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that includes a provision that would shield medical professionals from litigation if they withhold information from a woman about her pregnancy that may have resulted in her obtaining an abortion. The bill would also amend the state laws on abortion coverage, postviability abortion, abortions after 20 weeks postfertilization, abortion counseling, abortion training programs, abortion based on gender, tax credits for abortion-providing organizations, and sex education. No further action is expected since the legislature has adjourned its regular session.

LOUISIANA: In March, a U.S. District Court permanently struck down a Louisiana law that had permitted litigation against abortion providers for any “damage” caused by an abortion, even if there is no claim of negligence or malpractice. The Court struck down the law on the grounds that it is unconstitutionally vague and places an undue burden on women seeking abortion care, thereby violating the 14th Amendment.

MICHIGAN: In June, the House passed an omnibus abortion measure that would require medication abortion providers to carry at least $1 million in medical malpractice insurance. The bill, which also addresses clinic regulations, abortion counseling and medication abortion, is awaiting action by the Senate.

MISSOURI: In April, the House passed a measure that would require any provider administering medication for abortion to obtain additional insurance to cover potential liability if an infant is born as the result of an incomplete abortion. No further action is expected since the legislature has adjourned its regular session.

MISSOURI: In April, the Senate passed a measure that would require any provider administering medication for abortion to obtain an insurance policy to cover potential liability if an infant is born as the result of an incomplete abortion. The bill also includes provisions on medication abortion and a physician-only requirement. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) OKLAHOMA: In May, Gov. Mary Fallin (R) signed a measure that would allow a woman or the parent or legal guardian of a minor to sue if there was a violation of any of the laws on abortion counseling; mandatory ultrasound; provision of information on fetal pain to women who are at least 20 weeks pregnant; parental notification and consent; or another law on minors’ abortion. The measure will go into effect in September.

ALABAMA: In May, the House adopted an omnibus abortion measure that would limit surgical and medication abortion provision to physicians. The bill also includes provisions on clinic regulation, and would limit provision of medication abortion and require reporting of statutory rape. No further action is expected since the legislature has adjourned its regular session.

CALIFORNIA: In August, the Assembly passed a measure that would extend a program that trains midlevel practitioners, such as nurse practitioners and physician assistants, to perform first-trimester surgical abortions. The measure is awaiting action in the Senate.

(ENACTED) LOUSIANA: In June, Gov. Bobby Jindal (R) signed into law a measure that limits abortion provision only to physicians licensed in Louisiana. The new law goes into effect in August.

MISSISSIPPI: In July, a U.S. district court judge allowed enforcement of a law that requires any abortion provider to be certified in obstetrics and gynecology or eligible for such certification. The bill also requires abortion providers associated with an abortion facility to have admitting privileges at a local hospital. However, the judge ruled that Jackson Women’s Health Organization, the only abortion provider in the state, may not yet be penalized for “operating without the relevant privileges during the administrative process.”

MISSOURI: In April, the Senate passed a measure that would allow only physicians to provide and administer mifepristone, one of the two drugs used in a medication abortion. The bill also includes provisions on medication abortion and physician liability. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) WISCONSIN: In April, Gov. Scott Walker (R) signed a measure that limits provision of medication abortion to physicians and prohibits the use of telemedicine to administer medication for abortion. The bill, which also amends the state’s abortion counseling law, went into effect in April.

Prohibiting Coercing a Woman into Having an Abortion

Introduced in 4 states

Bill Status:

Passed at least one chamber in MI and VA

MICHIGAN: In March, the House passed a package of bills relating to coerced abortion. Together, these measures would amend state-mandated counseling procedures by requiring providers to screen patients for evidence of coercion and requiring providers to make available materials on violence against women. Abortion facilities would be required to post a notice informing women that they cannot be coerced into having an abortion. These measures are awaiting action in the Senate.

VIRGINIA: In February, a House committee defeated a bill that would make it a crime for any person to coerce a woman into having an abortion. The measure also enumerates civil penalties for persons accused of coercing a woman into having an abortion. The bill had passed the Senate in February.

Reporting Requirements

FLORIDA: In March, the House adopted an omnibus abortion bill that would require the Agency for Health Care Administration to develop an abortion reporting form that includes all the elements from the model developed by the Centers for Disease Control and Prevention. The bill, which would have also amended Florida law regarding clinic regulations, limits on abortion at a specific gestational age, “partial-birth” abortion, postviability abortion and abortion counseling and waiting periods, died at the end of the regular session

(ENACTED) GEORGIA: In May, Gov. Nathan Deal (R) signed a measure that revises the state’s abortion reporting requirements for abortions performed at 20 weeks postfertilization. The measure would require providers to report the medical diagnosis that necessitated the procedure after that point. The bill, which also limits abortion at or beyond 20 weeks’ gestation to cases of medical emergency or fetal anomaly, goes into effect in 2013.

MISSISSIPPI: In March, the House passed a measure that would require abortion providers to report all instances of medication-induced abortion and any “adverse events” from medication abortion to the state. The bill also contains a provision that would prohibit medication for abortion from being prescribed remotely through telemedicine. The bill missed a procedural deadline in the Senate and is no longer under consideration.

NEW HAMPSHIRE: In April, the Senate passed a measure that would create abortion reporting requirements for “partial-birth” abortions. The measure would require providers to report the specific medical diagnosis that necessitated the procedure. The bill, which also bans “partial-birth” abortions except in cases of medical emergency, is awaiting action by Gov. John Lynch (D).

NEW HAMPSHIRE: In April, the Senate requested that the state study the issues surrounding a potential ban on abortion at 20 weeks postfertilization (or 22 weeks after the woman’s last menstrual period), including reporting requirements. This amendment essentially blocks an attempt by the House to ban abortion at 20 weeks postfertilization for the year.

Self-Induced Abortion

Sex and Race Selection

Introduced in 10 states

Bill Status:

Passed at least one chamber in KS

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that would criminalize the provision of an abortion if the provider knows the woman is obtaining the abortion for purposes of sex selection. The bill would also amend the state laws on abortion coverage, postviability abortion, abortion at 20 weeks postfertilization, abortion counseling, provider liability, abortion training programs, tax credits for abortion-providing organizations, and sex education. No further action is expected since the legislature has adjourned its regular session.

State Employee and Facility Participation in Abortion

Introduced in 3 states

Bill Status:

Passed at least one chamber in KS

Enacted in KS

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed into law a measure that prohibits state employees or state agencies from participating in or facilitating abortion care. The bill also reenacts a priority-based system for the distribution of family planning funds and allocates funds for family planning services and alternatives to abortion. The new law is in effect.

KANSAS: In May, the House passed two identical measures and the Senate passed one measure that would prohibit state employees or state agencies from participating in or facilitating abortion care. The measure would allow medical residents at University of Kansas facilities to obtain optional abortion training, provided that it takes place outside of normal working hours and at a facility that is not funded or operated by the state. The bill would also create a priority system for distributing family planning funds, allocate funds for family planning and alternatives to abortion and reenact a priority system for distributing family planning funds. No further action is expected since the legislature addressed these issues in another bill.

KANSAS: In March, the Senate passed a measure that would prohibit state employees or state agencies from participating in or facilitating abortion care. The measure would allow medical residents at University of Kansas facilities to obtain optional abortion training, provided that it takes place outside of normal working hours and at a facility that is not funded or operated by the state. The bill would also create a priority system for distributing family planning funds and allocate funds for family planning. No further action is expected on this measure since the legislature addressed this issue in another bill.

ARIZONA: In January, the state agreed not to enforce a provision that prohibits citizens from claiming a tax credit for donations to any organization that “provides, pays for, promotes, provides coverage of or provides referrals for abortions.” The state’s move is in line with a U.S. District Court judge’s decision to block the tax credit provision from going into effect on the grounds that the law violates constitutionally protected free speech rights.

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that would amend the tax code to prohibit an organization that provides abortions from claiming tax credits for any business-related expenses. The bill would also amend the state laws on abortion coverage, postviability abortion, abortion at 20 weeks postfertilization, abortion counseling, provider liability, abortion training programs, abortion based on gender and sex education. No further action is expected since the legislature has adjourned its regular session.

Training for Abortion Providers Limited

Introduced in 2 states

Bill Status:

Passed at least one chamber in KS

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that includes a provision that would prohibit state employees or state agencies from participating in or facilitating abortion care. The measure would allow medical residents at University of Kansas facilities to obtain optional abortion training, provided that it takes place outside of normal working hours and at a facility that is not funded or operated by the state. The bill would also amend the state laws on abortion coverage, postviability abortion, abortion at 20 weeks postfertilization, abortion counseling, provider liability, abortion based on gender, tax credits for abortion-providing organizations, and sex education. No further action is expected since the legislature has adjourned its regular session.

Ultrasound Requirements

(ENACTED) ARIZONA: In April, Gov. Jan Brewer (R) signed an omnibus abortion measure, which includes a provision that requires a woman to undergo an ultrasound 24 hours before receiving an abortion. State law currently requires a woman to receive counseling at the facility at least 24 hours before the abortion, thereby requiring her to make two trips. The bill, which also includes provisions on admitting privileges for abortion providers, clinic regulations, limits on abortion at a specific gestational age, medication abortion and abortion counseling, goes into effect later this year.

IDAHO: In March, the Senate passed a measure that would require a woman to undergo an ultrasound before obtaining an abortion. The measure would also require providers to offer the woman the option to view the ultrasound image, receive a picture of it and listen to the fetal heartbeat. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) LOUISIANA: In June, Gov. Bobby Jindal (R) signed into law a measure that requires a provider to perform an ultrasound at least 24 hours before an abortion. The provider must also show and describe the ultrasound image to the woman, although she could opt not to view the image. Current law requires a provider to perform an ultrasound two hours before an abortion and offer the woman the option of viewing the image, hearing a description of it and receiving a picture of it. The new law goes into effect in August.

KENTUCKY: In February, the Senate approved a measure that would require a woman seeking abortion services to undergo an ultrasound prior to an abortion. The measure contains a provision that would require the ultrasound to be performed by the provider who performs the abortion. The woman would be offered the option of viewing the image and would have to listen to a detailed verbal description of it. No further action is expected since the legislature has adjourned its regular session.

OKLAHOMA: In March, a state district court judge enjoined an Oklahoma law that required a woman seeking an abortion to undergo an ultrasound prior to the procedure. The measure also required that the provider show and describe the image to the woman. The judge ruled that the law was unconstitutional because it applied only to abortion and not to other medical procedures. The state is expected to appeal the case to the Oklahoma Supreme Court.

TEXAS: In February, a US District Court judge allowed the state's law requiring an ultrasound before an abortion to go into effect. A woman who lives within 100 miles of the abortion facility must obtain the ultrasound at least 24 hours before the abortion, thus requiring her to make two trips to the facility. The provider must give her a detailed verbal description of the image unless she was raped, has a court order waiving parental consent or is ending the pregnancy because of a fetal abnormality.The provider will also offer her the option of viewing the image and listening to the fetal heartbeat.

(ENACTED) VIRGINIA: In March, Gov. Bob McDonnell (R) signed into law a measure that requires a provider to perform an abdominal ultrasound before an abortion. If the ultrasound cannot determine gestational age, the provider must offer the woman the opportunity, which she can refuse, to receive a vaginal ultrasound. A woman living within 100 miles of the facility must obtain the ultrasound 24 hours before the abortion, thus requiring her to make two trips to the facility. A woman who lives more than 100 miles away from an abortion provider must obtain an ultrasound at least two hours before the abortion. The bill contains an exception for victims of rape or incest that has been reported to the appropriate authorities. The law, which passed the legislature in February, goes into effect in July.

ADOLESCENTS

Minors Access to Reproductive Healthcare

MONTANA: In May, a district court judge permanently enjoined a statute and related regulations that prohibit the state’s Children’s Health Insurance Program (renamed Healthy Kids Montana) from covering contraceptives. The court found that the law and regulations violate minors’ right to privacy under the state’s constitution.

VIRGINIA: In February, a Senate committee defeated a measure that would have eliminated the requirement that girls receive the HPV vaccination in order to attend middle school. The bill passed the House in January.

Sex Education

DELAWARE: In June, the House adopted a measure that would require instruction on healthy relationships as part of teen dating violence prevention. The bill is awaiting action by Gov. Jack Markell (D).

KANSAS: In May, the Senate adopted an omnibus reproductive health bill that includes a provision that would prohibit a school district from using sex education instructors or materials from an organization that provides abortions. The bill would also amend the state laws on abortion coverage, postviability abortion, abortion at 20 weeks postfertilization, abortion counseling, provider liability, abortion training programs, abortion based on gender and tax credits for abortion-providing organizations. No further action is expected since the legislature has adjourned its regular session.

MICHIGAN: In July, the Senate adopted a measure that would require instruction on child sexual abuse from prekindergarten through grade five. Parents would be notified and given the opportunity to remove their student from the education. The bill is awaiting action in the House.

NEW HAMPSHIRE: In May, the Senate adopted a measure that amends the state sex education law to allow a parent to remove a child from sex education class for any reason. Current law requires that the removal be based on religious grounds. No further action is expected since the legislature has adjourned its regular session.

(ENACTED) OREGON: In March, Gov. John Kitzhaber (D) signed a measure that requires that students receive education on teen dating violence. The law goes into effect in January 2013.

UTAH: In March, Gov. Gary Herbert (R) vetoed a measure that would have required school-based sex education to focus exclusively on abstinence. The instruction could not include information on “the use of contraceptive methods or devices,” sex outside of marriage or homosexuality. The bill passed the House in February and the Senate in March.

(ENACTED) TENNESSEE: In May, Gov. Bill Haslam (R) signed a measure that revises the state’s sex education law. The new law requires sex education to “exclusively and emphatically” teach abstinence and provide instruction on the consequences of “nonmarital” sex; it cannot promote any activity that could lead to “nonabstinent behavior.” Contraception education may be included only if it does not promote sex among unmarried students and informs them that contraception does not eliminate the risk of pregnancy and STIs. The bill continues the state’s policy of requiring sex education only in school districts with a high teen pregnancy rate and retains the provision allowing parents to remove their students from the class. The new law goes into effect in July.

(ENACTED) WISCONSIN: In April, Gov. Scott Walker signed a measure that revises and repeals many of the provisions in the state’s sex education law. The bill repeals the requirements to provide contraception education, strengthens the abstinence education requirements and weakens the requirement that instruction be medically accurate. The law is in effect.

Statutory Rape Reporting

Introduced in 6 states

Bill Status:

Enacted in GA and MS

(ENACTED) GEORGIA: In May, Gov. Nathan Deal (R) signed into law a measure mandating that employees or volunteers of organizations that provide reproductive health services report child abuse. The new law goes into effect in July.

(ENACTED) MISSISSIPPI: In May, Gov. Phil Bryant (R) signed into law a measure that requires a physician performing an abortion on a minor younger than 14 to provide a tissue sample to the state bureau of investigation. The bill would also criminalize assisting a minor seeking an abortion without parental consent. The measure goes into effect in July.

Abortion-Related Restrictions on State and Family Planning Funds

ARIZONA: In July, a U.S. district court judge temporarily blocked enforcement of a law that establishes a priority system for the allocation of family planning funds that would exclude specialized family planning clinics. Under this system, state health facilities would have top priority, followed by hospitals and federally qualified health centers. Rural health clinics and primary health care providers could apply for any remaining funds. The bill also prohibits the state from contracting with providers or organizations that perform abortions for reasons other than life endangerment, rape or incest.

IOWA: In May, a conference committee deleted language from the state’s budget that would have required agencies to allocate family planning funds under a three-tiered priority-based system. Under this system, public facilities would have had the highest priority, followed by nonpublic facilities that provide primary health care and family planning services. Family planning providers would have been allowed to apply for any remaining funds. The measure would have also prohibited allocating funds to organizations that perform elective abortions or run facilities that perform such abortions. The bill passed the legislature in May.

KANSAS: In June, a U.S. District Court judge extended an existing court order that temporarily blocks enforcement of a provision in last year’s budget bill that prohibits specialized family planning providers from receiving Title X funds to an identical provision that was included in the budget adopted this year. Both provisions would limit allocation of Title X funds to state health agencies, private hospitals and federally qualified health centers. The judge found that there was a likelihood that the statute violates federal law by placing additional restrictions on the allocation of federal funds and discriminating against Planned Parenthood. The law will not be enforced until the resolution of the court case.

(ENACTED) MICHIGAN: In June, Gov. Rick Snyder (R) signed into law a measure that continues long-standing abortion-related restrictions on the distribution of family planning funds and extends those restrictions to maternal and child health funds. Specifically, the bill gives preference in the allocation of funds to organizations that do not provide abortion services. The new law, which also contains funding levels for family planning and alternatives-to-abortion services, is in effect.

MICHIGAN: In May, the Senate adopted the final version of the state’s budget that continues a long-standing restriction on family planning funds. None of the funds could be used “to encourage or support abortion services,” including counseling and referral. The bill would also require that funds for maternal and child health be allocated under a priority system that places abortion providers last on the list of recipients. The bill, which passed the Senate in April and the House in May, also contains funding levels for family planning services. Nor further action is expected since the legislature addressed these issues in another bill.

NEW HAMPSHIRE: In April, the Senate defeated a measure that would have established a four-tiered priority system for the allocation of family planning funds that excludes family planning clinics from eligibility. Under this system, public health organizations would have had the highest priority, followed by nonpublic hospitals, federally qualified health centers, rural health clinics and finally, private medical organizations that focus on primary health services. The bill would also have prohibited allocating funds to organizations that perform elective abortions or run facilities that perform such abortions.

NORTH CAROLINA: In June, a U.S. District Court judge permanently blocked enforcement of a law that would have prohibited any funds that go through the state treasury from being disbursed to Planned Parenthood. The judge found that the statute unconstitutionally violates federal law by impermissibly restricting the allocation of federal funds and discriminating against Planned Parenthood.

(ENACTED) NORTH CAROLINA: In July, the legislature voted to override Gov. Beverly Perdue’s (D) veto of a measure that limits the allocation of family planning funds to local health departments and prohibits the allocation of these funds to private family planning providers. The law is in effect.

TEXAS: In April, a U.S. district court judge temporarily blocked enforcement of a regulation that would prohibit organizations associated with abortion from participating in the state’s family planning expansion. Within hours, this injunction was overturned by a judge on the U.S. Court of Appeals for the Fifth Circuit. In May, two judges also sitting on the U.S Court of Appeals for the Fifth Circuit reinstated the injunction of the law.

Budget Bills: Family Planning Line Items

(ENACTED) COLORADO: In May, Gov. John Hickenlooper (D) adopted the state’s budget bill that continues a long-standing prohibition against giving state family planning funds to organizations that provide abortion services with their own funds. The bill, which also allocates funding for family planning services, goes into effect in July.

(ENACTED) COLORADO: In May, Gov. John Hickenlooper (D) signed the state’s budget bill that allocates more than $6.5 million for family planning services, a similar amount to that allocated for the current fiscal year. The bill, which retains the long-standing prohibition against giving state family planning funds to organizations that provide abortion services with their own funds, goes into effect in July.

(ENACTED) CONNECTICUT: In June, Gov. Dan Malloy (D) signed into law the state’s budget, which allocates slightly more than $1 million for family planning services. The new law goes into effect in July.

(ENACTED) DELAWARE: In July, Gov. Jack Markell (D) signed into law the state’s budget that allocates $325,000 for family planning services, an amount that represents level funding for the line item. The law is in effect.

(ENACTED) FLORIDA: In April, Gov. Rick Scott (R) signed into law a measure that would allocate more than $4 million for family planning services. The bill, which passed the legislature in March, goes into effect in July.

(ENACTED) GEORGIA: In March, Gov. Nathan Deal (R) signed into law a supplemental budget bill that includes funding for family planning. About $40 million is allocated for teenage pregnancy prevention, tobacco use prevention, cancer screening and prevention, and family planning services. The bill also cuts $80,000 from family planning services. The bill, which passed the legislature in February, is in effect.

HAWAII: In March, the House passed a measure that would allocate an unspecified amount of funding for family planning services. The bill is awaiting action in the Senate.

(ENACTED) ILLINOIS: In June, Gov. Patrick Quinn (D) signed into law the state’s budget, which provides $495,000 in state funding for family planning services and allocates $9 million for Title X family planning services; this is essentially the current funding level. The law goes into effect in July.

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed into law a measure that allocates funding for the state match needed to receive federal family planning funds under the Title X program, an amount that is similar to funding levels allocated in recent years. The bill also reenacts a priority-based system for distributing family planning funds, funds alternatives to abortion and limits state employee participation in abortion. The new law is in effect.

(ENACTED) MAINE: In May, Gov. Paul LePage (R) signed into law a measure that cuts about $400,000 from the “Fund for a Healthy Maine,” which reduces the total funds allocated for family planning services by 25%. The new law goes into effect in July.

(ENACTED) MASSACHUSETTS: In July, Gov. Deval Patrick (D) signed into law the state’s budget that allocates about $4.7 million for health services, including family planning services; this is essentially the current funding level. The law is in effect. .

(ENACTED) MICHIGAN: In June, Gov. Rick Snyder (R) signed into law a measure that allocates nearly $10 million for family planning services and nearly $15 million for the state’s Medicaid family planning expansion. This represents current funding for family planning services and an 8% increase for the Medicaid family planning expansion. The new law, which also restricts family planning funds and funds alternatives-to-abortion services, is in effect.

MICHIGAN: In May, the Senate adopted a conference committee report that would allocate nearly $10 million for family planning services and nearly $15 million for the state’s Medicaid family planning expansion. This represents current funding for family planning services and an 8% increase for the Medicaid family planning expansion. No further action is expected since the legislature addressed these issues in another bill.

(ENACTED) MINNESOTA: In April, Gov. Mark Dayton (D) signed into law a measure that allocates about $1 million in federal Temporary Assistance to Needy Families (TANF) funds for family planning services. The bill, which passed the Senate in March and the House in April, goes into effect in July.

(ENACTED) MISSOURI: In June, Gov. Jay Nixon (D) signed the state’s budget bill that allocates $9.5 million for family planning (mostly Title X) services. The law, which passed the legislature in May, goes into effect in July.

(ENACTED) NEW JERSEY: In June, Gov. Chris Christie (R) signed into law the state’s budget, including a line item that would allocate $4.2 million for Title X family planning services. The law goes into effect in July.

NEW JERSEY: In June, Gov. Chris Christie (R) vetoed a supplemental appropriations measure that would have allocated nearly $7.5 million for family planning services. The bill, which passed the legislature in June, also contained a provision on Medicaid family planning expansions.

(ENACTED) NEW YORK: In April, Gov. Andrew Cuomo (D) signed into law a measure that allocates nearly $26 million for family planning services; this is essentially the current funding level. The law is in effect.

(ENACTED) PENNSYVANIA: In June, Gov. Tom Corbett (R) signed into law the state’s budget that allocates $2 million of the federal social services block grant for family planning funding. The new law, which also provides funding for alternatives to abortion, is in effect. .

(ENACTED) SOUTH CAROLINA: In July, Gov. Nikki Haley (R) signed the state's budget that allocates nearly $24 million for family planning services. This allocation represents a $2.6 million cut in funds for family planning. The new law also prohibits state employees’ health insurance from covering abortion.

(ENACTED) VIRGINIA: In May, Gov. Robert McDonnell (R) signed into law the state’s budget bill that allocates nearly $48 million for family planning services over the next two years. The new law, which was enacted as part of a special session, goes into effect in July.

Insurance Coverage

ARIZONA: In May, Gov. Jan Brewer (R) signed into law a bill that allows a “religiously-affiliated employer” to offer a health plan that does not cover contraceptives based on the religious objections of the employer or a beneficiary. An employee can receive reimbursement for contraceptives prescribed for noncontraceptive medical purposes. The bill defines “religiously-affiliated employer” as either a nonprofit that primarily employs and serves individuals that share the nonprofit’s religious beliefs or as an organization that has incorporating documents that clearly state that religious beliefs are “central to the organization’s operating principles.” The new law goes into effect in August.

GEORGIA: In March, the Senate passed a measure that would define a “religious employer” and exempt them from the state’s contraceptive coverage mandate. Currently, the state’s contraceptive coverage mandate does not permit any employer to opt out of the coverage. No further action is expected since the legislature has adjourned its regular session.

MISSOURI: In July, Gov. Jay Nixon (D) vetoed a measure that would have extended a current law allowing employers, insurers or employees to be exempt from the state’s contraceptive coverage mandate because of religious objection. The measure would have also authorized the state Attorney General to protect these rights with regard to the federal health care law. The measure was approved by the legislature in May.

NEW HAMPSHIRE: In May, the Senate removed provisions of a bill that would have allowed religious employers to refuse to provide contraceptive coverage if the objection is based on religious beliefs. Currently, the state’s contraceptive coverage mandate does not permit any employer to opt out of the coverage.

OKLAHOMA: In May, a conference committee removed language from a bill that would have allowed an enrollee in a health plan to opt out of abortion or contraceptive coverage if the objection is based on religious beliefs.

Medicaid Family Planning Eligibility Expansions

(ENACTED) INDIANA: In February, Gov. Mitch Daniels (R) signed into law a bill that requires the state to apply for a state plan amendment to expand Medicaid family planning services. Individuals are eligible for services if their income is at 133% or below of the federal poverty level. The bill also specifies that abortions or “a drug or device intended to terminate fertilization” would not be covered under this program.

NEW JERSEY: In June, Gov. Chris Christie (R) vetoed a supplemental appropriations measure that would have directed the state to expand Medicaid family planning services through an amendment of its Medicaid plan. Individuals would have been eligible for services if their income was at 200% or below of the federal poverty level. The bill, which passed the legislature in June, also contained a provision on funding for family planning services.

TEXAS: In August, a three-judge panel of the U.S. Court of Appeals for the Fifth Circuit upheld a regulation that prohibits organizations associated with abortion from participating in the state’s family planning expansion. The judges disagreed with a lower court’s opinion from April that held that the regulation violated Planned Parenthood’s freedom of speech rights.

(ENACTED) VERMONT: In March, Gov. Peter Shumlin (D) signed the state’s budget bill, which requires the commissioner of Vermont Health Access to prepare rules and procedures for the adoption of a state plan amendment for family planning services.

Partner Treatment for Sexually Transmitted Infections

(ADOPTED) ARKANSAS: In June, the State Medical Board adopted rules that permit physicians to prescribe or dispense a drug for treatment of chlamydia or gonorrhea for a patient’s partner without first seeing the partner. The regulation is specific to heterosexual partners. The regulations are in effect.

(ENACTED) IDAHO: In March, Gov. Butch Otter (R) signed into law a measure that allows a medical practitioner, based on CDC recommendations, to treat a patient’s partner for chlamydia and gonorrhea without having seen the partner. The law goes into effect in July.

Pharmacy or Pharmacist Requirements to Dispense Contraception

WASHINGTON: In February, a U.S. District Court judge found that the state’s regulation that requires pharmacies to fill all valid prescriptions and provide access to emergency contraception could not be enforced against Ralph’s Thriftway (a grocery store with a pharmacy) and two pharmacists. The judge concluded that the regulation violates the U.S. Constitution by impermissibly “targeting religious conduct.” The state is expected to appeal the decision to the U.S. Circuit Courts for the Ninth Circuit.

PREGNANCY & BIRTH

Fetal and Pregnant Woman Assault

Introduced in 14 states

Bill Status:

Passed at least one chamber in CO

Enacted in TN

Vetoed in NH

COLORADO: In March, the House passed a measure allowing someone to be charged with homicide or assault if their actions cause the injury or death of an “unborn member of the species of homo sapiens.” No further action is expected since the legislature has adjourned its regular session.

NEW HAMPSHIRE: In June, Gov. John Lynch (D) vetoed a bill that would have allowed a fetus that is at least nine weeks’ postfertilization to be considered a victim of homicide. (A veto override attempt by the legislature in late June failed.)

(ENACTED) TENNESEE: In May, Gov. Bill Haslam (R) signed into law a measure that includes an embryo or fetus at any point in gestation as a victim of homicide. The existing fetal homicide law does not indicate when in pregnancy the law applies. The bill excludes actions by a woman and legal medical care. Current law includes an exception for medical care, but not for the woman’s actions. The new law goes into effect in July.

HIV
Testing of Infants and Pregnant Women

Introduced in 5 states

Bill Status:

Enacted in DE and WV

(ENACTED) DELAWARE: In June, Gov. Jack Markell (D) signed into law a measure that requires a health care provider to offer HIV testing to a pregnant woman whose HIV status is unknown when she enters the third trimester or during labor and delivery. The woman is allowed to refuse the test. Currently, a medical provider must offer testing to a pregnant woman in the third trimester if she is deemed to be at high risk for contracting the disease. The law is in effect.

(ENACTED) WEST VIRGINIA: In April, Gov. Earl Ray Tomblin (D) signed into law a measure that approves a regulation adopted by the Bureau of Public Health. The regulation requires HIV screening of pregnant women in the routine panel of prenatal tests, unless the woman declines. Also, an HIV test can be performed on an infant born to a mother who has not been tested for HIV. The bill, which passed the Senate in February and the House in March, is in effect.

Infant Abandonment

(ENACTED) MINNESOTA: In April, Gov. Mark Dayton (D) signed into law a measure that allows emergency service personnel to accept a relinquished infant who is seven days old or younger. Current law allows a health care provider to accept relinquished infants 72 hours old or younger. The bill, which passed the Senate in March and the House in April, goes into effect in August.

(ENACTED) MISSISSIPPI: In April, Gov. Phil Bryant (R) signed into law a measure that explicitly protects the anonymity of the parent relinquishing a newborn under the state’s infant abandonment statute. The bill, which passed the Senate in March and the House in April, goes into effect in July.

MISSOURI: In May, the House passed a measure that would allow a parent to legally relinquish an infant who is 45 days old or younger. Current law allows a parent to relinquish an infant aged one year or younger. The bill would ensure the protection of the parent’s anonymity and would add pregnancy resource centers and maternity homes to the list of locations where an infant can be relinquished. No further action is expected since the legislature has adjourned its regular session.

Infertility
Coverage

Non-Medical Use of Ultrasound

Stillbirth Certificates

Introduced in 8 states

Bill Status:

Passed at least one chamber in NM

Enacted in IA

(ENACTED) IOWA: In March, Gov. Terry Brandstad (R) signed into law a measure allowing a parent who loses a fetus after 20 weeks of pregnancy to obtain a certificate of birth resulting in a stillbirth. The new law is in effect.

NEW MEXICO: In February, the Senate passed a measure that would allow a parent who loses a fetus to obtain a certificate of birth resulting in stillbirth. No further action is expected since the legislature has adjourned its regular session.

Substance Abuse During Pregnancy

(ENACTED) COLORADO: In March, Gov. John Hickenlooper (D) signed into law a measure that prohibits evidence of substance abuse during pregnancy from being used in criminal prosecution if the evidence was discovered through a pregnancy test or prenatal care screening. The bill, which passed the legislature in February, is in effect.

DISTRICT OF COLUMBIA: In May, Mayor Vincent Grey (D) approved a measure that would require a health care professional to report to child and family services if an infant younger than one year is diagnosed with fetal alcohol spectrum disorder. The bill is awaiting approval from Congress.

(ENACTED) KENTUCKY: In April, Gov. Steve Beshear (D) signed into law a measure that allocates nearly $1.4 million over two years for substance abuse prevention and treatment for pregnant women. The bill, which passed the legislature in March, goes into effect in July.

(ENACTED) MISSOURI: In July, Gov. Jay Nixon (D) signed into law a bill that repeals the provision requiring the department of health to coordinate services for women with high-risk pregnancies who have abused illegal substances. The bill goes into effect in August.

(ENACTED) OKLAHOMA: In April, Gov. Mary Fallin (R) signed into law a measure that mandates that the Department of Human Services investigate when a newborn tests positive for controlled substances. The bill, which passed the House in March and the Senate in April, goes into effect in November.

UTAH: In April, the Utah Human Services, Child and Family Services Agency approved regulations that would include exposure to alcohol or other “harmful” substances in utero in the state’s definitions of abuse, neglect and dependency. The regulation is in effect.

(ENACTED) VIRGINIA: In April, Gov. Bob McDonnell signed two measures that amend the state’s law on child abuse reporting. The bills require a health care provider to report to the Department of Social Services any diagnosis of fetal alcohol spectrum disorder or other medical condition caused by exposure to controlled substances during pregnancy. Current law limits reporting of those conditions related to prenatal alcohol and drug exposure within seven days of birth. The provisions go into effect in July.

REFUSAL
CLAUSES

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed a measure that expands the state’s refusal clause for abortion and potentially contraception. The new law allows an individual to refuse to perform, make referrals for or participate in abortion services or services the individual “reasonably believes” would end a pregnancy. Current law permits an individual to refuse to perform or participate in an abortion. The new law also permits a health care facility to prohibit “the performance, referral for or participation in” abortion services or services that the facility “reasonably believes” would end a pregnancy. Current law allows a hospital to refuse to permit the provision of an abortion. The law goes into effect in July.

MISSOURI: In May, the House adopted a bill that would allow health care providers and institutions to refuse to perform, assist or provide referrals for services related to abortion, abortion-inducing drugs and contraception. It would also prohibit the state from requiring pharmacies to stock any prescription or non-prescription contraceptive drugs or devices. The pharmacy and refusal provisions were subsequently removed by a conference committee, so that the version of the bill awaiting action by Gov. Jay Nixon (D) amends only the laws related to coverage of abortion and contraception.

MISSOURI: In March, the House adopted a measure that would add to the laws that permit health care providers and facilities to refuse to participate in abortion. The bill would permit health care providers, including social workers and health care facility employees, to refuse to participate in, or provide counseling or referral for abortion, contraception and other specific health care services if the objection is based on religious, moral or ethical beliefs. A refusal would not be permitted if a patient’s life was endangered. Currently, the state permits individuals and private and public hospitals to refuse to provide abortion services. No further action is expected since the legislature has adjourned its regular session.

Health Professionals

Introduced in 11 states

Bill Status:

Passed at least one chamber in MO

Enacted in KS

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed a measure that expands the state’s refusal clause for abortion and potentially contraception. The new law allows an individual to refuse to perform, make referrals for or participate in abortion services or services the individual “reasonably believes” would end a pregnancy. Current law permits an individual to refuse to perform or participate in an abortion. The new law also permits a health care facility to prohibit “the performance, referral for or participation in” abortion services or services that the facility “reasonably believes” would end a pregnancy. Current law allows a hospital to refuse to permit the provision of an abortion. The law goes into effect in July.

MISSOURI: In May, the House adopted a bill that would allow health care providers and institutions to refuse to perform, assist or provide referrals for services related to abortion, abortion-inducing drugs and contraception. It would also prohibit the state from requiring pharmacies to stock any prescription or non-prescription contraceptive drugs or devices. The pharmacy and refusal provisions were subsequently removed by a conference committee, so that the version of the bill awaiting action by Gov. Jay Nixon (D) amends only the laws related to coverage of abortion and contraception.

MISSOURI: In March, the House adopted a measure that would add to the laws that permit health care providers and facilities to refuse to participate in abortion. The bill would permit health care providers, including social workers and health care facility employees, to refuse to participate in, or provide counseling or referral for abortion, contraception and other specific health care services if the objection is based on religious, moral or ethical beliefs. A refusal would not be permitted if a patient’s life was endangered. Currently, the state permits individuals and private and public hospitals to refuse to provide abortion services. No further action is expected since the legislature has adjourned its regular session.

Insurers

Introduced in 4 states

Bill Status:

Vetoed in MO

MISSOURI: In July, Gov. Jay Nixon (D) vetoed a measure that would ensure the rights of individuals to refuse health coverage for abortion without incurring penalties. The measure would also allow insurance purchasers, such as employers, and insurance providers to opt out of providing coverage for abortion care. The bill would also authorize the state Attorney General to protect these rights with regard to the federal health care law.

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed a measure that expands the state’s refusal clause for abortion and potentially contraception. The new law allows an individual to refuse to perform, make referrals for or participate in abortion services or services the individual “reasonably believes” would end a pregnancy. Current law permits an individual to refuse to perform or participate in an abortion. The new law also permits a health care facility to prohibit “the performance, referral for or participation in” abortion services or services that the facility “reasonably believes” would end a pregnancy. Current law allows a hospital to refuse to permit the provision of an abortion. The law goes into effect in July.

MISSOURI: In May, the House adopted a bill that would allow health care providers and institutions to refuse to perform, assist or provide referrals for services related to abortion, abortion-inducing drugs and contraception. It would also prohibit the state from requiring pharmacies to stock any prescription or non-prescription contraceptive drugs or devices. The pharmacy and refusal provisions were subsequently removed by a conference committee, so that the version of the bill awaiting action by Gov. Jay Nixon (D) amends only the laws related to coverage of abortion and contraception.

MISSOURI: In March, the House adopted a measure that would allow health care providers and facilities to refuse to participate in contraceptive services. The bill would permit health care providers, including social workers and health care facility employees to refuse to participate in, or provide counseling or referral for abortion, contraception and other specific health care services. A refusal would not be permitted if a patient’s life was endangered. No further action is expected since the legislature has adjourned its regular session.

Health Professionals

Introduced in 8 states

Bill Status:

Passed at least one chamber in MO

Enacted in KS

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed a measure that expands the state’s refusal clause for abortion and potentially contraception. The new law allows an individual to refuse to perform, make referrals for or participate in abortion services or services the individual “reasonably believes” would end a pregnancy. Current law permits an individual to refuse to perform or participate in an abortion. The new law also permits a health care facility to prohibit “the performance, referral for or participation in” abortion services or services that the facility “reasonably believes” would end a pregnancy. Current law allows a hospital to refuse to permit the provision of an abortion. The law goes into effect in July.

MISSOURI: In May, the House adopted a bill that would allow health care providers and institutions to refuse to perform, assist or provide referrals for services related to abortion, abortion-inducing drugs and contraception. It would also prohibit the state from requiring pharmacies to stock any prescription or non-prescription contraceptive drugs or devices. The pharmacy and refusal provisions were subsequently removed by a conference committee, so that the version of the bill awaiting action by Gov. Jay Nixon (D) amends only the laws related to coverage of abortion and contraception.

MISSOURI: In March, the House adopted a measure that would allow health care providers and facilities to refuse to participate in contraceptive services. The bill would permit health care providers, including social workers and health care facility employees to refuse to participate in, or provide counseling or referral for abortion, contraception and other specific health care services. A refusal would not be permitted if a patient’s life was endangered.No further action is expected since the legislature has adjourned its regular session.

Insurers

Introduced in 3 states

Bill Status:

Vetoed in MO

MISSOURI: In July, Gov. Jay Nixon (D) vetoed a measure that would have extended a current law allowing employers, insurers or employees to be exempt from the state’s contraceptive coverage mandate because of religious objection. The measure would have also authorized the state Attorney General to protect these rights with regard to the federal health care law. The measure was approved by the legislature in May.

Pharmacies or Pharmacists

Introduced in 6 states

Bill Status:

Enacted in KS

(ENACTED) KANSAS: In May, Gov. Sam Brownback (R) signed a measure that expands the state’s refusal clause for abortion and potentially contraception. The new law allows an individual to refuse to perform, make referrals for or participate in abortion services or services the individual “reasonably believes” would end a pregnancy. Current law permits an individual to refuse to perform or participate in an abortion. The new law also permits a health care facility to prohibit “the performance, referral for or participation in” abortion services or services that the facility “reasonably believes” would end a pregnancy. Current law allows a hospital to refuse to permit the provision of an abortion. The law goes into effect in July.

REPRODUCTIVE HEALTH AND ENVIRONMENTAL HAZARDS

Bisphenol A (BPA)

Introduced in 23 states

Bill Status:

Passed at least one chamber in IL and SD

ILLINOIS: In May, the House adopted a measure that would ban the use of BPA in reusable bottles and cups for children younger than three. The ban would be applied in two stages. Manufacturers and wholesalers would be barred from selling reusable bottles and cups that contain BPA as of January 2013; this ban would extend to retailers as of January 2014. The bill is awaiting action by Gov. Patrick Quinn (D).

SOUTH DAKOTA: In February, the Senate defeated a measure that would have prohibited the use of Bisphenol-A (BPA) in baby bottles and sippy cups designed for children younger than three. The bill passed the House in February.

Dioxin

Flame Retardants

Introduced in 10 states

Bill Status:

Passed at least one chamber in AK, NJ, NY and WA

ALASKA: In April, the Senate adopted a measure designed to limit the use of flame retardants. The bill would limit the amount of pentabromodiphenyl, octabromodiphenyl and decabromodiphenyl in consumer products, including mattresses, upholstered furniture and the housing that contains electronics. The bill would also allow the state to prohibit the use of flame retardants if the chemical is harmful to public health and the environment and a safer alternative is nationally available. No further action is expected since the legislature has adjourned its regular session.

NEW JERSEY: In June, the Senate adopted a bill that essentially bans the sale or manufacture of consumer products containing a widely used flame retardant chemical (decabromodiphenyl ether). Cars, planes and trains would be exempt from the ban, as would products developed for military purposes and any product that is entirely created from recycled materials. The bill is awaiting action in the Assembly.

NEW YORK: In March, the Assembly adopted a measure that bans the use of a widely used flame retardant (decabromodiphenyl ether) in electronic products, such as computers and televisions, distributed in the state. The ban does not apply to products that have transportation and military uses. The bill is awaiting action in the Senate.

WASHINGTON: In February, the Senate adopted a measure that would limit the amount of a common flame retardant (tris(2-chloroethyl) phosphate) in children’s products. The bill is awaiting action in the House.

Lead

Introduced in 16 states

Bill Status:

Passed at least one chamber in NY

Enacted in LA, NE and VT

(ENACTED) LOUISIANA: In June, Gov. Bobby Jindal (R) signed a measure that requires some facilities built before 1978, such as schools and day care centers that serve children younger than seven, to be tested for lead. The facility is not required to be tested if it has already undergone testing. Test results that exceed acceptable levels would be reported to the state and to the parents of children who use the facility. The new law goes into effect in August.

(ENACTED) NEBRASKA: In April, Gov. David Heineman (R) signed a measure that requires children enrolled in Medicaid to be tested for lead. The bill also recommends lead testing for children who live in zip codes that have a high prevalence of children with elevated lead levels or for children who meet state-specified criteria. The bill goes into effect later this year.

NEW YORK: In June, the Assembly adopted a bill that would essentially ban the use of lead in children’s lunchboxes and bibs. The bill would also require the state to monitor lead levels in candy. The bill is awaiting action in the Senate.

(ENACTED) VERMONT: In May, Gov. Peter Shumlin (D) signed a measure that amends the state’s law regulating the amount of lead in children’s products. The bill would exempt food and vitamins from these regulations. The new law went into effect in May.

Mercury

Introduced in 19 states

Bill Status:

Passed at least one chamber in NY and VT

Enacted in CT, OR and WI

(ENACTED) CONNECTICUT: In June, Gov. Dan Malloy (D) signed a measure that requires the recycling of mercury-containing thermostats by January 2013. Manufacturers of mercury-containing thermostats would be required to develop collection and recycling programs.

NEW YORK: In June, the Senate adopted a measure that would require thermostat manufacturers and retailers to develop recycling programs for used mercury-containing thermostats. These programs would have to be operational by July 2013. The bill is awaiting action in the Assembly.

(ENACTED) OREGON: In March, Gov. John Kitzhaber (D) signed a measure that limits the amount of mercury in fluorescent lamps.

WISCONSIN: In April, Gov. Scott Walker (R) signed a measure that prohibits the sale of zinc air button cell batteries, commonly used in hearing aids and cameras, that contain mercury. The law went into effect in April.

Parabens

Pesticides

Introduced in 5 states

Bill Status:

Passed at least one chamber in the District of Columbia

DISTRICT OF COLUMBIA: In August, Mayor Vincent Gray (D) signed legislation that directs the Department of the Environment to develop regulations that prohibit the use of pesticides near schools and child-occupied facilities, except under certain circumstances. The signed bill is awaiting action by the U.S. Congress.